Category Archives: Society

Question: How many of us can remember our country’s national anthem? Another question: How many of us can claim to know the philosophy behind each verse? Yet another question: How many of us can proudly state that we live each day full of that philosophy?

Point made.

A week back media reports and the press, the public, members of political parties were agog with anticipation over the outcome of the so-called ban over the singing of the National Anthem in the elite schools of Pakistan. Endless debate, arguments and counterarguments later, an independent observer would witness every verse of the National Anthem in question, being sadly torn to shreds in spirit in any such ‘discussion’. The public in general feels strongly about the National Anthem and rightly so. However, more importantly, what is it that makes an anthem an anthem? What does an anthem even stand for? These are the questions that need to be answered before we start repeating parrot-like statements about the National Anthem being our pride and spirit and being ‘very important’. The question is, WHY?

The answer: simply because an anthem reflects the ideals of a nation – state and the foundations on which it stands and that is why it is important to know and understand it. Remember – know AND UNDERSTAND it, not rote learn it. And I’ll connect this factor later in this text.

Today I attended a discussion related to the issue of banning the National Anthem in the city’s elite schools at a cafe in Karachi, Pakistan. Here are a few of the salient features of that discussion that I found interesting. Almost all the participants of the discussion were unanimous in saying that the National Anthem being sung every day was not as important as following the ideals of what has actually been mentioned in the Anthem. The fact that the only word in the Anthem ‘ka’ (of) is in Urdu and the rest is actually in Persian, was also brought forward. There was also some amount of debate over the fact that this is not the original Anthem that was approved by Quaid e Azam Mohammad Ali Jinnah and the original was written by a Hindu Poet from Lahore: Jagan Nath Azad. One senior participant went as far as to say that she could take up to a month to just teach the philosophical aspects behind the verses and lamented the fact that schools barely teach our children ethical ideals nowadays. Another participant – a young mother, mentioned how she had been educated in an elite school and how her school mates were now not even in Pakistan and remained barely connected to the place in spite of having sung the National Anthem every day for the whole of their school lives. A point was also raised for the behaviour of people during the recital of the Anthem and how in cinema halls many are too busy to even stand up or how naughty young children are involved in their own pranks and begin to take the recital as something of a bore. The discussion ended with a strong vote in favour of promulgating a movement to include the National Anthem as part of the syllabus and teach it in the light of its philosophy.

Continuing the point I had made earlier at the start of this write up, what exactly is the philosophy behind the singing of National Anthem every day? Revival of the Nationalistic Spirit? Drilling the National Anthem into the head so it can be repeated as and when needed?

Irrespective of who wrote the National Anthem, which one should or should not have been selected and what people do with their lives once they grow up and decide of a place to settle down, the focus needs to be on what we glean from the Anthem in the first place. There is no formula to ensure that people will stay or not stay on in Pakistan after learning or not learning the National Anthem or even understanding its philosophy in a month or a year. And even if people decide to stay on after acquiring an education here, it is entirely a different debate on how ethically they will lead their lives. Personal life, family, society, their own perspective have an immense influence on it all, that cannot ever be attributed only to the words of the Anthem.

So what can be a better alternative? Is the daily recital of the Anthem a must? What exactly do we achieve or hope to achieve by this? There cannot be just one right answer to this. Patriotism is not a variable directly proportional to the amount of times one recites the National Anthem.

That being said, it is the prerogative of the schools to decide what their policy should be. I am proud to have studied in a school (termed as non-elitist) where not only was the National Anthem recited daily but we recited our school’s own Anthem as well, yet it is not the recital that makes me proud. Many of the students would not be able to recite more than a few lines of it at this point in their lives in spite of having recited it daily for ten years. However what will remain with many of us for most of our lives was the manner in which it was explained to us by our teachers through relevant examples from life. They taught us not only the philosophy behind the verses, but through their own behaviour showed us the dedication, the hard work and the spirit that goes into the making of an institution and a country. These are the values that we need to reflect and focus on.

The sparks of the debate over the National Anthem may now be dying down but they have nevertheless triggered an important knee jerk in the public consciousness. There is need yet to re-examine the manner in which our current syllabus is being taught. Our children learn Pakistan Studies and the fourteen points of Jinnah diligently yet barely know what each stands for. We rote learn the Anthem, stand up slackly when it is played, get Goosebumps at the tune and feel our spirit soar – but it all becomes as momentary as an autumn leaf each time we throw that wrapper up in the air into the arms of the kishwar e haseen, when we let the tap run dry in the arz e Pakistan, when we break the rules and regulations and slip that bank note under the table to the man on the opposite end breaking the Paak sarzameen ka nizaam and when we kill our brothers and ruin the quwwat eakhuwwat e awam.

May we all collectively reach our desired destination, our manzil e murad and may the road be one of peace, not the rocky one towards which we now seem headed where words become more important than deeds.

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Tid bits from my take on life in 2011. For the latest, click on the tab above.

06/08/2011 Ramazan Rage and the Money Game

Its the 5th day of Ramazan and already I can sense a strange disquiet on the roads. Nothing new in that, except that the rush, the inching in to get in or out of line, the looks and stares have started earlier than usual this year.

Political observers attribute this as ever to the conditions of the economy and the country in general. Psychologically, only extreme examples of food deprivation come to mind, none of which seem to fit here. Hunger for a limited time, when one knows that there will be an end to it, causes mild irritation for sure if prolonged and with the additional factor of burning heat added, but the reactions we have on the roads are in excess of what is expected. Perhaps another dimension is that over some period of time we have been losing our levels of tolerance. It can be sensed in the way the direct-pick-up-the-mobile instead of calling on landline translates into an incessant honking of the horn outside the gate and the idea that the person wanted inside the house will fly out in a matter of seconds. Another horn happy instance can be seen in a traffic jam where many feel it to be their duty to herd the commuters along. A very young version of me once revelled in the idea of owning Chitty chitty bang bang or Knight rider, only to discover that it was a shared dream with others. Now I shudder. If we Pakistanlings are unable to follow properly demarcated roads then how on earth will we follow aerospace rules?

Ramazan rage and swindling is on the rise this Ramazan.

Another money making scheme was just witnessed on Main Khayaban e Jami, Karachi where a tiny little school van came packed with goodies today. As I write this, this farcical scheme is still going on where a company by the nonexistent name of Aryan Enterprises has supposedly launched a dubious custard packaging with a prize scheme – get a ‘free’ blender, tv, sheraton dinner or Nokia N73 cellphone if the coupon yields that name – all for a paltry 1400 rupees. The catch: the France made blender is actually a ‘Mounelux’ instead of Mouleneux (meet the Bata – Beta version), the cell phone with a sheepish admission when confronted, turns to a made in China cheap revision, the TV suddenly goes from a made in Korea to dubious Malay origins and the men incharge earlier smiling and pleasing, turn into the sheepish, sidelong glances types when charged with fraud.

And this is just the beginning of Ramazan. Stay tuned for more from the roads of Karachi. Au revoir.

22/05/2011 Neighbourly batting

Just got a phone call from an irate neighbour questioning my take on child psychology when I don’t return her son’s cricket balls. Now should I really explain the consequences of negative punishment? Well, positive reinforcement and negative reinforcement both having failed, time for the big ‘P’. Thats my take on it for now.

In addition I have been told that the cricket balls WILL continue to fall in my house and I should deal with my negative emotions; and that ofcourse there is a 1 in 100 chance of getting hit by one (it narrowly missed me a few days back), and ofcourse cricket balls are not strong enough to break windows of a car or a house. Im totally re-educated! The icing on the cake: I also learnt that this is how children learn to bat sixers otherwise how else will they learn?! I suddenly have visions of young Afridi in knickers having half the neighbourhood running after him with sticks.

So wherein lies the soloution? It truly is a sad fact that we barely have enough playgrounds for children in the city. Yet, there is one very near my house and there happens to be just that someone who can take this kid out to play there. So, till I find another solution, long live negative punishment. Though in this case after hearing a lot of irrational beliefs, I’d say the mother needs it more than the child.

Yesterday night I was hit by a revelation. Today it hit harder as I actually said it in front of a friend.

I was printing out a manual for Reiki level 2 when looking at the hand positions and the conceptual framework I was struck by how close the entire concept is to Islamic Practices of Namaz and Roza, Saum o Salat. The conceptual framework including meditation – relaxation – focussing on the words – placement of the hands … it all falls into place. Reiki linked with places we touch, Yoga linked with how we move and bend, Meditation linked with how we focus on removing external worries while we focus on His names. The list goes on and on. While we are praying it is not for Allah only; it is He who has created this system for us so that we are purified by the process. Reiki may well call it the flow of the eternal life force.

Bottom line – If one can take out time for Reiki, one can take out time to pray. The most natural and best God given gift to Man – provided one focusses, lets go of external stressors while praying and most important of all: ‘believes’! Pure Taqwa.

30/04/2011 Water, water everywhere…

Water. It is not just Man’s basic need but essential to all life on Earth. Imagine if this necessity were to become a luxury…And this is exactly what may happen and soon enough if we are not careful in water conservation – and here by conservation the reference is not just to its use but also its abuse ranging from overuse to the addition of various pollutants.

A case in point is that of Manchhar in our very own country where high levels of pollutants caused avoidable casualties. The current devastation caused by the recent floods (2011) is also a case in point after which the pollution level has increased further. It is said that the Government has undertaken to provide compensation to the families of the victims… Yet the question remains: who are we to blame? The Government, as a convenient target; the industries, for emptying their pollution into the pure Pakistani waters: or ourselves, for sitting and watching…and watching…

28/4/2011 Psychology of Terror

I have just come within inches of a bomb blast today. On my way to work I saw ambulances, sirens blaring rushing past and several police vans. This is the third blast in a bus in 2 days. I don’t know how long this madness will last where innocent people are killed daily and yet fingers point all around. The blame game doesn’t end does it?

Terror comes in various garbs and the one that is most potent is the one that injects fear in the masses. Overdose of fear can at times lead to apathy like the proverbial switch that has become faulty due to overuse. Right now, perhaps apathy is our double edged sword – the defense that keeps us going and the withdrawal in our own shells and little worlds that leads to social ignorance and carelessness.

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As a child it was fascinating yet quite a bit disturbing to be with certain old people at times. They would ask you your name over and over again or their hands would tremble so much that it was scary to be near them. Yet the way they smiled and their love and care cannot be denied. For the young child who has yet to see and know much of disease and despair, the revelation can be disturbing, yet growing up with it can teach a lot in the name of patience and humility.

Years later after a sojourn into the sketchy roads psychology can take us along; I have a name for the various issues caused by this condition. Dementia – or the cognitive decline in daily life functioning is a term that has both the aforementioned scenarios attached to it and more.

When I was younger, I grew up in a family where it was obvious that older parents and grandparents would be taken care of by their relatives. Not doing so was unthinkable and inexplicable. Tempers flared, grievances were common on both sides of the generational divide and one learned that this is how things moved on. Age brought on various issues and life had to move on accordingly. In my clinic now, I notice a change that has hit our conservative collectivistic culture several years after it was already an established ‘western’ tradition. The younger generation has a greater tendency to have both genders working long hours. Taking care of the elderly is no longer considered a first priority in many cases as it used to be earlier. Consequently the concept of old people’s homes is talked about in hushed tones but nevertheless – talked about.

Each story can have several angles and so does this one. One may argue that better nursing care is available at old people’s homes or centres such as this – an extremely derogatory name of a proposed dementia-ville of sorts that has health care professionals divided in opinion http://www.independent.co.uk/news/world/europe/switzerlands-dementiaville-designed-to-mirror-the-past-6293712.html . On the other hand there is much to be said for old fashioned home care. While round the clock health care facilities are provided at such spaces they are no replacement for the ease of living if provided in one’s own home in familiar surroundings. I have seen several instances where those with a moderate degree of dementia do very well when under the supervision of health care practitioners who may also train the caregivers to create cues for the patient. While the facility such as the one mentioned here may be an open door facility that would help in a rather advanced stage of Alzheimer’s, there are people doing extremely well in the home with nursing attendants or family members. Surely it is difficult, but not impossible. At the same time, even those suffering from dementia such as Alzheimer’s disease need a change and day long facilities may be just the right amount of change. Family members need to take care of their own health as well and providing round the clock nursing to an often irritable person can be a heavy task unless one is blessed with a rather large family with someone there to cater to various needs round the clock. Some respite may be provided by day care facilities which would go a long way towards keeping things harmonious at home. Younger children can learn from the patience and sacrifice invested in the process of home care and the family system can develop beautifully. There is after all, a lot to be said for the value system of taking care of elders in the circle of life just as they once did when we were young.

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Browsing through an array of notifications that hits my screen every few minutes or so, I was recently stirred by an ongoing debate on one forum. The topic in question was about the efficacy of the Karachi zoo and whether it should even exist or not. Keeping for and against points towards one side, quite a case can be made for both aspects.

Perhaps one of the things that struck me the most was how many people there were right! If I existed in my bubble I would undoubtedly say that having a zoo in Karachi is a useless venture and be done with it. Yet, my bubble was broken long ago. Agreed, that in the case of the zoo it is quite painful to see the animals slumbering in smelly cages, especially the ever sleeping lion, yet it could be taken as a personal opinion. I am completely against the concept of keeping any wild or pet creature in a cage. It is against nature, demeans God’s creations and is tantamount to cruelty which no religion or civil society teaches. Reminds me of St Mary’s asylum in Bethlehem and the commotion it caused in history because there humans were being treated in the same way as animals. Think for a minute of our own selves in those cages and it is enough to make one shudder.

At the same time, I’ve come to realize that change cannot be pushed forward impulsively. One needs to remove a brick and place another in its place so the infrastructure doesn’t collapse. The zoo wasn’t made in a day and the jobs even though being understaffed are provided for and cater to several families. At the same time, there is a case for using the zoo as a ready made lab for the creation of a healthy genetic pool for endangered species.

On the other hand, conservationists feel that the main reason the zoo has survived so far as an open place in the heart of the city is because we have a valid excuse ‘there are animals in it and it’s a recreational space’. Without that excuse there is little between a bullet and a bullet to stop land grabbers. And we do need that open space as a breathing space in the middle of the city. Further while we of the car and facebook world bubble have our dens and haunts, many women living in the locality look forward to the day when it’s a ladies only day and they can easily spend their time there. On special occasions, ladies are not allowed inside and yes, there may be several pickpockets. I was once told that on such days men rule the place and sadly consider it great fun to poke animals to make them react. Brutal and callous yes, but the more we shut down and avoid such instances instead of re-educating, we are not giving anything to society. The concepts will not change.

The need of the day is to plan carefully and listen to different views as well along the way. There may be more than just animals at stake here. Food for thought… There should be adequate provision of open places for entertainment for masses rather than the elitist population only.

One of my earliest memories is of seeing finally all those wonderful animals that I had before then seen only in books as a five year old child. The wonderment and pleasure at the size and beauty of it all in that bright afternoon is a happy memory. So it is with others, photographers and nature lovers alike who go and spend time at the zoo on cloudy days and enjoy the open space. On good days it is still a great place to be. Long winding walks, greenery and the vast expanse of land make it an ideal picnic spot as well, especially for those who do not have the means to bear with the expense of carting their offspring to the beach and buying goodies for them there from the shops dotting the area. The convenience of the location as well as the economy of biying sweets and affordable snacks from vendors near the zoo cannot be undermined.

One suggestion of dealing with the knotty issue at hand is of converting the current facility into a focus on a petting zoo with pet animals in open spaces and trained staff to guide children how to handle such animals. Baby animals and pets may be better able to elicit responses of warmth than of poking and ridicule and change the concept of the zoo as many have it at present.

The problem with most petitions is that they communicate aggressive action and impulsivity – they denounce something and do not provide suitable alternatives. As a result many noteworthy causes fall flat as those in the Government feel they will face additional protests from a variety of people especially the employees if they listen to the voices of concern from civilian bodies. A shelter or petting zoo is a good alternative that would keep the space and the jobs intact, while getting rid of the abhorrent and expensive to maintain wildlife in cages concept with an always sleeping lion to go with it. He definitely needs to be out in the jungle where he belongs.

As for shutting down the zoo? Definitely NOT an option.

For a view of the improvements made in the zoo since its inception and to know more about the history, I recommend reading:

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Good old rainy ‘moonsoon’ or ‘MANsoon’ season courtesy the creative tongues of our media wallahs, is here again in Karachi. After a dry spell of several years and the last memorable drown-the-roads rain in 1992, we seem to be getting it all back again. While no animals or male species can be seen pouring from the heavens, the ones on the street are a sorry sight. Stranded on the roads, stuck in jams of their own making, the people of Karachi face their biggest friend turned enemy – water. The city infrastructure just can’t digest any more rain and there may just be a guttery Venice in the making.

Grumble or rumble, this is the Karachi of my childhood, the roads where I have steered that ‘kaghaz ki kishti’ (paper boat), splashed in puddles, got drenched in the rain and smelt the earth together with crispy fried goodies, heard the buzz in the air of happy sounds of laughter, shrieks of joy on spotting a rainbow in the sky and got stuck in HUGE adventures being stuck in the middle of water with open manholes dotting the way; not knowing which step would take me down under and these are the lessons I’ve learnt:

1. When it rains it pours, see one drop and run.

2. Necessity is the mother of all, if you don’t have a raincoat, wear a ‘shaaper’ (shopping bag) on your head.

3. All that is water, may not be water – watch your step!

4. Make hay while the sun shines, have a bath while it rains.

5. If someone splashes you from one side, splash him on the other.

6. When life gives you lemons make lemonade, when it gives you rain in Karachi, make pakoras, mosquito repellents and generators.

7. It doesn’t matter if you’re revealingly wet all over, all your ‘izzat’ (dignity) happens to be atop your head, which MUST be covered on a priority basis.

8. Look before you leap, you may just find an open manhole hidden beneath.

9. Every cloud has a silver lining, make sure your clothes do too!

10. Every dancer has her days, and sometimes they lead to rain.

11. Avoid air and water like the dengue, wear a tent!

12. There is water at the end of every tunnel, learn to swim!

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Torrential downpour in the country, emergency situation due to floods in Badin, earthquake of 5.7 magnitude in Karachi and Balochistan and the Anthem record of 5000 plus enthusiastic people braving the lashing rain and wind in a stadium in Defence, Karachi – we finally usher in Pakistan’s 64th anniversary celebrations.

image courtesy Google.com

The land of green and the sea of blue,

The Quaid had thought it a dream come true,

Freedom from injustice and every kind of harm,

It would provide the muslims with a much needed balm…

A much younger version Kiran had written these lines on the occasion of Pakistan’s 50th anniversary. 14 years later, the idea of ‘freedom from injustice and every kind of harm’ rings in my ears. Negative portrayals have far overtaken the positive aspects in media reports.

Think positive we are told, and then the buzz dies down after 14th August as the days pass. There are those silent workers who continue their work… the Edhis of the age who never even solicit limelight while their worldly counterparts aka politicians light up million dollar smiles while doling out ration and supplies to the poor.

Google doodles have finally given in to repeated demands and come up with a suitable portrayal of the 23rd March monument of the famous Pakistan resolution monument and the crescent and star symbol replete with green and white colour.

Green for the muslim masses and white for the minorities – or the sum total for the ideals of purity. A secular state? Iqbal’s dream or Quaid e Azams? Changing of the guards ceremony at the mazaar – the Navy taking over as guards in the wake of the PNS Mehran incident; are they worthy or not? The debatable issues are endless, but is it even worthwhile getting into these debates?

The ones who want to work do not need to have every little detail cited and clarified, before starting their work. While the time for action bit may be a cliche’ , it stands before us clearer than ever today.

64 years have passed since Pakistan’s freedom. What freedom you ask? The freedom of choice.

In our lives each one of us has boundaries. In the true sense, none of us is ever or ever can ever be completely ‘free’. The bonds of religion may restrict one, the bonds of family may restrict another and so on.

Freedom of choice is the only idea that allows us to move in the little squares we step on in our daily lives. Today, if you decide to use this freedom of choice to do a good deed, howsoever small it may seem, who can stop you? And if we all decide to use our time and endeavour to do something good, the ripple effects will surely grow.

So, go and give someone the gift of your time; talk to a person who is ill, handicapped, facing life’s troubles and heal the pain. Go and give someone the gift of hope. Show someone that you care, be it human, animal or plant life. Live within that square you have been boxed into… Its the message in the lights of those mobiles that came on at the National Anthem record when there was no light…

Where there is a will, there is a way and today will be a new day if you make it different in some way… Will you?

There are instances when theory doesn’t exactly translate into practice – rather as I call it, it undergoes a transduction process. Each fragmented element, becoming whole through subjective perception. Let’s just say that the Khorwah medical camp held on 31st July 2011, barely a day before Ramadan, was another of such instances. A brainchild of the 4×4 Offroaders Club, this was my first experience with this group in their medical camp and their dedication to the cause is appreciable.

Khorwah, is located in the north east of Karachi and it took us almost 4 hours to reach there by bus. The land may be fertile for paddy fields but it is a hard life for the locals who have a hand-to-mouth living at best. The main profession in the area is hiring oneself out as farm labourers and its secondary adjunct is grazing cattle. A few luckier ones, according to the local definition of ‘luck’, are ironsmiths or carpet weavers, basket weavers and tradesmen who do not have to undergo the hardship of toiling in the hot climate.

While a quick online search shows that there are apparently two schools in the vicinity for boys and girls, not one of the children we came across has ever attended a school there and several of the elders shook their heads when asked about the existence of a school. Another ‘ghost school’ perhaps? From a psychological perspective the absence of a school makes the task of psychologists harder for the assessment of children. How does one gather data for any child’s achievement level when there is no available baseline? Simon – Binet and Wechsler, the fathers of intellectual testing, take the backseat in the face of pastoral and cultural dynamics. For my part, I found that I could easily add in a number of intelligences to Gardener’s Theory of Multiple Intelligence while assessing intellectual ability based on performance in Khorwah.

Towards Sujawal and beyond

The harsh climate, the financial hardships, the lack of knowledge, the focus on medicine only as the cure-all, and the disinterest in prevention over symptomatic treatment are definite barriers to creating awareness of diseases and disorders. There is also a tendency to label all mental issues as ‘pagalpan’ or madness – no matter what the age of the person under speculation. The language and dialect barrier is also hard to overcome. A slightly different inflection of the voice even if close to the original Sindhi word, was very difficult for the people, especially the womenfolk to understand. However, all is not as bleak as it looks. There is a definite interest in learning new ways and in the fact that for once there is a ‘different kind of doctor’ – someone who cares, wants to help and is ready to listen and, with no disrespect on my part, is not ‘just a journalist who will listen, go back and write or publish photos and not offer any concrete suggestions for our ailments’. Children with behavioural, intellectual and emotional issues were curious, and eager to try out new exercises yet too afraid of the doctor label to be able to open up and relax.

Most of the prevalent diseases are a result of poor health awareness and future programmes can be chalked out to include large scale group therapy with at least one translator available per group. This time we initiated a focus group venture but it did not succeed too well due to the low voice of the translator and addressing partial groups in the audience, neglecting those seated at a distance. It also didn’t help that the translator had her own views regarding what would help the women and what would not and most of the sentences spoken had to undergo negotiation before they were translated. Some of the women who had partially understood the sentence followed the negotiation ball as in a tennis match with frustration writ large on their faces.

A group of local women with the volunteer doctors

Among the common issues faced by the villagers that would require preventive awareness programmes, skin diseases are almost at the top of the list, and poor hygiene conditions make it very difficult to say that these will be eradicated anytime soon. The villagers walk barefoot in the fields in all weather and deformed calluses caused by incessant scratching and its resultant sores that may get infected, are very common. Again the issue is greater in women than in the men, who being seen as the main breadwinners, are less likely to go barefoot. Hand washing is a luxury and whether scratching sores, or tending to cattle or cleaning up their own or their children’s faecal matter with stones and leaves or hands, just a quick sieving of the fingers through sand or a nearby muddy pond is considered enough to cleanse the hands. The same hands then return to their own body, to the food they cook and the utensils in which they eat and drink. Clothes are not washed more than once in two weeks if there is time left over from working in the fields. Cotton cloth is tied round, washed after a day and reused in times of menstruation. Several women believe that having a bath during menstruation is bad for health and here the case was no different. I witnessed many garments soiled and stained with blood that are not washed at all and are kept aside only to be worn during the time of menstruation on a monthly basis. There is dire need of awareness and presentation of cost effective, easy alternatives to deal with the hygienic aspects of preventive health care in the region. Abdominal aches due to intestinal worms and other genitourinary problems

Another issue is of oral and dental health care. Many women are addicted to various substances used by their husbands and chewing hard betel nuts coupled with calcium deficiency along with other forms of nutritional deficits, leads to brittle teeth, swollen gums and cavities. There is hardly any concept of brushing or even the traditional ‘miswak’ or ‘tooth stick’ use and dry twigs are used if anything gets stuck in between the teeth. The use of salt as a cleansing agent was advocated in front of quite a few women as a cheaper alternative to fill Dentonic bottles once they would get empty. Children were especially eager to show off shiny teeth and this factor can always be used to motivate them on future occasions.

PNS Shifa hospital affords us psychologists at the Institute of Professional Psychology, a cushioned existence. It has taken us a while to build up our reputation and most doctors here at PNS Shifa now know what we do, we have interlinks and they many refer cases easily. With the medical camp we went back to basics. I was all the while strongly reminded of the words of our colleagues working in remote areas and in other parts of interior Sindh. It took awhile to tell people at the camp a number of things. Firstly that psychologists do take a long while to diagnose and treat but depending on the type of test or clinical interview, diagnosis can be a quicker deal especially in cases of psychosis and neurological issues, secondly the fact that therapy and counselling does take a number of sessions but there are a number of techniques that can be taught in a shorter time and thirdly the idea for the patients that psychologists are not journalists and they ask questions to diagnose, not write only and that medicines are not a cure-all, there are times when medicines are just not needed. In this entire process I hope we have re-educated more than just the visitors. It was heartening to see many men come forward to discuss their wives genitourinary issues after they had been silently observing us from a distance and felt that they could get some assistance from this ‘different’ method of treatment and develop some understanding about how to deal with such issues. I was extremely glad to see one patient in particular who approached us on his own after watching us from a distance. He was worried about his wife’s growing weakness and low mood and a complete clinical interview revealed that she had been suffering from post partum depression since the past one year. He went back encouraged to know the dynamics of the disorder and a few pointers to help her deal with this period of stress.

The Medical Camp site sans tables and chairs that were earlier lined up with numbers assigned for each doctor's table. Beautifully organized.

In a hospital setting such as the one in which we are based, we take it for granted that in case of any illness – terminal or otherwise, the caregivers will need to be counselled about the mode of care, their issues of anger or treatment follow up and prevention but in Khorwah, out in the open it hit us hard that there are people out there who need to understand that still. Similarly, many patients with chronic chest conditions were referred to us directly and we asked them to first see the general practitioner and then approach us on their way out.

Clinical Psychologists who are interested in the types of psychological issues faced at this remote area and the interventions we used for them would find it interesting that we went far off the beaten track with generally good results. Neurological problems were at the forefront of most cases seen and neurological screeners were applied for evaluation along with intakes. The rush at the camp made many children nervous, cranky and prone to tantrums which made this test very difficult and reinforcement in the form of biscuits generally helped in soothing more than one terrified child. Children also kept thinking that they were going to receive an injection as soon as they closed their eyes for a few subtests and refused outright to close their eyes even for a few seconds. It would be idealistic and demanding to expect a secluded spot for such testing in a medical camp but we improvised by taking a few patients slightly away from the camp for relaxation and guided imagery in the case of anxiety disorders as well as the motor subtests of the neurological screeners. Some patients were referred to hospitals in Karachi for further medical treatment. They were also provided with guidance about occupational therapy and its correlates and demonstrations were given to each patient individually about the simple exercises they could do at home to help improve the gait or eye-hand coordination.

another view of the Medical Camp site

Complete diagnosis and treatment for many patients with psychotic features could not be initiated at the camp but initial diagnoses revealed Schizophrenia with prominent visual and auditory hallucinations and they were again given detailed directions for seeking psychiatric help in Karachi. Most of the patients earlier had no idea what to do about this condition of madness and had been at the mercy of faith healers who were fleecing them. Their caregivers were guided about their conditions, expectations, possible prognosis and types of treatment along with modes of care, and do’s and don’ts.

Suicidal ideation, suicidal attempts, self mutilating behaviour and depressive features with melancholic states were observed in a number of women. Considering the financial state and the early marriages, childbirth issues, and other problems these women face this does not come as a surprise. A number of Conversion disorder and Somatisation cases that had been labelled as various pain issues gradually floated over to the Psychologists’ table after getting a negative from other doctors present. Far more had been noticed when conversing with the women during the group therapy initiative. Contrary to what some doctors feel, it is important to state here that Conversion and Somatisation are distinct from Malingering and just because there is no physical evidence for the patient’s condition, it does not always mean that he is indulging in attention seeking behaviour or wishes to gain some material benefits. The managers of the estates will as a rule complain about the labourers not working properly and defining a patient as alright and having no pain just because nothing comes up during the course of the physical examination does not mean that from now on the patient will be fine. Conversion symptoms are like the flow of a river. You can barricade the pressure, but temporarily. Eventually, the course may change, the walls of the patient’s self may tumble down or he may experience other similar symptoms incorrectly labelled by many novices as Hypochondriasis. A better alternative is to refer such a case to a psychologist who can then deal with the entire etiological presentation of the case.

While there are successes, there are stark facts of unforgiving and harsh circumstances in many cases. A few really saddened us and I still think of the old man who was caught in a catch-22 situation. An ironsmith by profession, he showed initial signs of Parkinsonism, was well aware of the changes in his body and yet he had been abandoned to his current state by his six sons who considered this trade a demeaning one, did not help him financially and he was still looking after his two daughters. Only one son helped him from time to time and he too rebuked him and had been distancing himself from his father. In another case, a man who was the sole breadwinner suffered from severe congestion and asthmatic symptoms each time he was involved in threshing procedures. He had no idea about safety procedures and used no form of protection whatsoever. He was counselled briefly regarding safety procedures and provided with suitable alternatives.

The entire initiative on the part of the 4×4 Offroaders was well executed and very well organized in terms of crowd control from start to finish and I’m sure it is not the last one! The whole team deserves to be congratulated and I’ll refrain from taking any one person’s name in particular as each and every member was immensely dedicated. There is always room for improvement and I’m looking forward to the next trip already. Let’s see how many suggestions can be utilized and how far it is possible to correctly identify patients at source or educate each other about our respective roles so that maximum benefits can be derived from everyone’s contributions.

N.B. All the photos were taken by me after the camp was almost over and during the camp there was no time to take photographs. Hence there are no photographs of the doctors or the patients undergoing treatment. A safe estimate, however is that nearly 800 – 1000 patients visited the camp that day and were given free medicines, free treatment and physical and mental examinations.

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If weather was an indicator of how things are on ground, the skies would rain ash. Its ironically lovely outside right now with just a hint of softness in the cool breeze while countless tyres burn on Karachi’s main artery, twitter is abuzz with MQM, PPP and ANP political parties’ love-hate triangleship and the vast majority of the citizens cower at home for fear of losing an arm, leg or precious neck.

See no evil, hear no evil and speak no evil needs a revision. The newer version could read “see everything, don’t hear, don’t speak’. For we all know what happens to those who do. Swan songs aplenty in the journalist world to remind us of consequences.

And what about tolerance? Bookish knowledge some say. Time for action, say others. The result? Mobs going wild and the scars of the 90’s in Karachi scratched and bleeding once again.

Extremism has no religion. A resident of Balfour's Siyabuswa township runs for cover as service delivery protests turned violent.

Extremism is a word, not a religion. Cross border dialogues turn into hate tirades and finger pointing but at the end of it all is an individual. In my short period of analysing extremist culture over time in different people from around the globe and more so in Pakistan, the picture has been multidimensional. There are those who feel angry and frustrated by events at a local or international level or those who grow up in the unjust world of lanes where might is right and in order to survive, one must hit hard. Many turn to religion using basic belief systems sans any analysis or psychosocially appropriate zeitgeist and use dogmas to establish an easy basis for intolerance. In order for me to be right (and obviously I am right), you must be wrong.

Many others use an extremist identity to resolve their own inner conflicts – a sense of belonging, a sense of support that makes them go on in life, provides them with purpose and eventual fulfilment. Life satisfaction as a double edged sword one may say. It would be a happy ending for all concerned if that ideology would stay contained. Yet, as the followers grow, it spirals into a movement instead and group-think being the time-ticking-bomb it is, it is bound to create a sense of fulfilment now in group ideals. Hence aggression and all its associated features come into play.

Karachi has been a bloody playground for party people since ages. Partition and a hunky dory time period passed in a dream and then we had individuals who spoke – the young student leaders who later banded, disbanded and created group-think. Now, its not even group-think, its instinct-think and the law of the jungle integrated. The one with the loudest voice – literal or metallic, gets heard and then there is an even louder silence.

MQM behind my removal as home minister: Zulfiqar Mirza.

Now we have Zulfiqar Mirza with his anti-MQM statements and the people’s voiceless but action filled rebuttal? Among the nameless faces of pyromania there are quite a few having a party and the venue happens to be the road outside. While Federal Interior minister Rehman Malik apologized on behalf of Mirza to appease the offended, dogs, a donkey, several public transport vehicles and private cars have borne the brunt of most of the anger. Goodbye ozone layer. Hopefully we won’t need you. Goodbye effigies and goodbye outbursts, the people need something more substantial that cringes and whines. Such is the mindset of a tough minded audience while peace lovers look on in shock and disgust. Hundreds gather near Zulfiqar Mirza’s home in Karachi, children chant slogans like a mantra and the onlookers far outnumber the activists. There are videos of people clapping and dancing in rallies in Badin, Hyderabad and other parts of Pakistan. If it were not for the burning tyres, the whole thing would look like a festival. Bonfire anyone?

Understood, no one likes to be called ‘hungry and naked’ and be reminded insolently that they were provided shelter; much in the manner of a landlord lording over his bonded labourers, yet is Zulfiqar Mirza’s speech incentive enough for anger? Were offended Karachiites hot headed enough to leap to action at the whip of a tongue of flame? A tongue is a tongue, not a gun and while an apology has been made to the hurt sentiments of the migrant populace, the unwittingly blown speech bubble includes names, and party politics along with an entire community. It will not be an easy task to smooth out everything in 48 hours by issuing ultimatums to those with a tongue to leave the city while the city dwellers vent their feelings conveniently by smashing their own utensils. Truly the angry mind doesn’t think. By the same formula, heaping all Urdu speakers into a pile and associating all of them with the name of MQM doesn’t work either.

TV channels are having a field day replaying the video taped speech over and over again. Much like a cricket ball by ball commentary we have shots of the background revealing who shook his head, who didn’t, who smiled, who tapped who on the shoulder and when. Welcome to the world of masala mix.

Time to make a third amendment for in-tolerance: See nothing, hear nothing and most definitely SPEAK NOTHING. And ofcourse those who are blind, deaf and dumb will do nothing.

Yet among all the gore, there are glimmers of light – the population that can differentiate between the right to speak and the right to vent was till yesterday sending sympathetic messages for the unfortunate blasts in Mumbai and receiving equally thankful and understanding responses from the other side. Flip side of the coin, Pakistan and Afghanistan again gained an infamous image for exporting terror. Export? Both are busy battling the weeds in their own gardens.

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I wrote a short poem titled ‘Our mega-village’ way back in 1998. I had recently found out back then that Karachi is actually technically known as a mega city in line with others like Mumbai, London, Paris and New York etc. 14 million people approximately in 1998 = mega city. It is 2011 now. Irony: My words written back then ring true more than ever today.

Case in point: My area in Karachi has been without electricity for the past 36 hours and counting… KESC (Karachi Electric Supply Corporation) workers who are happily on a strike have ‘unofficially’agreed to fix the ‘tranformers’ ‘PMTs” for Rs 200 per house. DHA (Defence Housing Authority/Society) area is the worst struck. Known as one of the ‘poshest’ areas of the city, it calls for greater attention ‘ofcourse’ as the revenue through bribery is expected to be higher than any of the others. Hence while other areas of the city function as normal – with occasional loadshedding thrown in to remind residents of the power (all pun intended), DHA residents boil in the heat. No electricity or lack of generators equals lack of water in tanks. In some areas the rates are Rs 1000 per house and Rs 20,000 per lane. Even after payment the power supply has not been resumed. Hence we have a bleary eyed me posting this page from the past of 1998 coupled with regret and a resounding echo in 2011…

In a bygone era it was a novelty,

for people who went to stay in villages,

without water, gas or electricity.

But now we can enjoy that very same state

just by living in this mega-city!

23/06/2011 Update: 52 hours and counting and no sign of electricity supply as yet. Freezer items have perished yet surprisingly enough, Man’s resilience shines through. We have learnt to co-exist. The cool sea breeze is helping as well after days and days of blistering heat as Nature seems to be taking sides here.

A colleague reported that Rs 20,000 was the price for getting the PMT in her area fixed. Even then, power supply was restored after 48 hours. Another friend reported interesting scenes outside the KESC office where all bearded and cloth-above- the-ankle workers were seen lined up for a hunger strike with another line of lemonade (nimbu pani) and rooh afza (local sherbet) selling pushcarts right beside them. If beards are an emblem of humility and God fearing attributes, I wonder why we are being told that police protection is necessary for those who want to help and fix PMT (transformers) in the vicinity?

I hear menial workers making fun of the educated, sophisticated sufferers for their stupidity in not being daring enough to step out of their homes, bash up KESC workers and set fire to tyres on main roads. If that defines ‘daring’ in this country now, I wonder what will become of the word ‘tolerance’… ?

Update at 23/06/2011 (10:30 pm) from the dark. A kescwala affirms that other ousted kesc workers attack those who come to fix things.

A friend from PECHS congratulates me on suffering only for 4 days now as she got electricity back after 5 days… I’m actually lucky for once. Wow!

Meanwhile things look bleak in DHA especially in Phase VII where despite repeated promises, KESC or the Darakhshan police have always managed to miss each others’ timings. Residents in the meanwhile have turned it into a war situation leaving the menfolk in some houses at the forefront and the women and children being shunted off to the cooler climes of other relatives with light. Meatless days… lightless days. All in the same boat.

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A few minutes ago courtesy the twitter brigade and a few who live near the PAF base, I have just been informed of the fifth blast for today inside PNS Mehran on Shahrah e Faisal, one of the major arteries of Karachi city and still the drama continues. (23/05/2011 at 12.30am) . Read on to get a round up of the events till now.

If reports are to be believed, the base was being used to build certain P 3 Orion planes using US army help. These are highly sensitive and expensive planes that help detect fully submerged submarines at great depths and distances. These reports also state that parts of these planes had been brought in around 18 months ago and the area was known to be quite secure. One fully built plane was destroyed in the attack and tentative estimates reveal, that this has also left at least 5 people dead and numerous injured. Around 15 terrorists reportedly entered the area and so far 6 have been killed.

Televised images have been horrific indicating a state of siege with ambulances piling up in front of the gates within minutes of the first blast and being kept there due to the continuous firing going on inside. Hats off to the commandos who were sent in to fight amidst pitch darkness as the entire area has been cordoned off by police and rangers to limit the escape routes towards Dalmia cement factory aka Dalmia road and the link route via Karsaz road.

While the controversy theories abound it is interesting to note that most of the world has been interested in how the terrorists got in, in the first place and very few comment on what has been happening in there between the first group of blasts and the second. There was silence in between and then suddenly the firing restarted with people reporting yet another blast, making it the fifth in a series. The fact is that PNS Mehran covers a huge area and there are several dark spots where people could have gone right over the wall with none being any wiser. The bhains ka paara (cow and buffalo pen) and pipline / gutter / manholes theories are also coming in focus with a couple of ladders conveniently placed for the world to see. Why such a major operative did not remove the ladders immediately after, is anybody’s guess. Another theory suggests the guise of security personnel for the terrorists who just calmly walked in. Thats something indigestible. In a place where everyone knows the other – especially guards on duty, it is quite difficult to suppose someone just casually walking by unless the identity is not only known but the venture was a joint and collaborative one. Again, we can not possibly blame all and sundry fo this security lapse. Nothing in the world is foolproof, least of all security. Loyalties can be bought, places exchanged and tongues sealed.

As for the manner in which they reached the said area undetected and were not apprehended till the first rocket was fired, the clothes of the men, the tme of night and the fact that they were on foot is self explanatory when put together and highly believable. I have been in the vicinity several times and been stopped for security checks but then I was always in a car, whether day or night. The area is not a flat and barren land but has bushes and adequate vegetation to act as suitable hiding places. Reason suggests that this was not a one time operation but that a recce of the place had been conducted earlier to make this a possibility by outlining all the ways of getting to their target. Once over the wall, or through the pipeline etc, the gray / black clothing of the men in the dead of night in even a highly patrolled area could have easily gone undetected.

Media coverage lacks incisive and indepth analysis at this time which is not surprising given the current state of affairs and the number of breaking news reports over the past few hours. The International media picked up the thread one hour later than the Indian media which was quite an eyebrow raiser.

While speculations abound on every side, one can not help but feel for the people inside who are dealing with the mayhem on the ground. The bravado of ambulance drivers and volunteers also deserves a mention for being there for their duty at such a time while others sit in their cosy nooks and tweet about how Pakistan is a failed state, how Pakistan deserves all this and worse still how the Navy, Airforce and all armed forces had this coming to them. There is yet another bunch rejoicing that tommorow will be a holiday for educational institutes in the vicinity. Whither humanity?

This is the third incident in a month where the Pakistan Navy has been attacked. The firs two involved Naval buses and led to the deaths of innocent doctors. Healers became the victims and were treated at the same hospitals where they worked. Calling it irony would be an understatement.

The scene is of a battlefield and all the questioning in the world isnt helping
navy personnel at this moment. People are anxious to know exactly how, why ,
when this happened and when it will end. The answer to that can not be given
immediately. This is hardly a cricket match with all the details known. My
friend reports firing at the premises even now after 14 hours have passed since the first rocket was fired before 11 pm on 22 May 2011. Its an area with human lives who are and can be used as shields. The ones who have gone in with the terrorist agenda have taken in food and water to last them for 3 days. Only 14 hours have passed as yet. It will be a miracle if they can gas and get them out of there for who knows if they have also had the forethought of taking in gas masks. If they had rocket launchers to destroy the P 3 Orion planes then they could well have anything else as well.

As I write this, a part of Karachi is burning. Sirens are blaring and newscasters are struggling to keep up with the onslaught of news coming their way. Its enough to drive an action movie enthusiast mad, thinking movies have come alive. And this is real life.

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Pakistan’s development programme 2001 – 11 under the heading of ‘CULTURE, SPORTS, TOURISM AND YOUTH: TEN YEAR PERSPECTIVE’outlines lack of recreational facilities and vocational skill training as the prime issues facing the youth. It further delineates programmes to establish youth hostels and tourist resorts, create youth development centres and providing I.T. training as major goals. Youth empowerment by any other means and involvement in policy making is not at all touched upon, if ever indeed even spoken of as a possibility.

The PC-1 form of the ‘ten year perspective’ was revised in 2005. A deeper analysis may reveal what aspects were revised and how far ground breaking work overweighed paperwork. This article aims just to present the facts and not the analysis. It is up to the thinkers to process it all further. The PC-1 includes at the end, the briefest possible outline. Barely a passing reference is made to the ‘Youth’ sector. See for yourself:

Culture, sports, tourism & youth

• Existing and projected flow of tourists in the country/project area.

• Relationship of archaeological projects with internal and foreign tourism.

Mass media

• Indicate area and population to be covered with proposed project.

Research

• Indicate benefits of the research to the economy.

• Mention number of studies/papers to be produced.

• Indicate whether these studies would result in commercial application of the process
developed (if applicable).

The 10-year time period is almost over and in 6 months we will reach 2012. The last two subheadings involve a great deal of paperwork and cannot be judged easily, but the citizens have every right to know what has been done for the first subheading written above. A subheading that ironically stands for four different sectors and mentions only two!

Our youth, the clichéd ‘asset’ of any country are disillusioned and dissatisfied with the current state of affairs. Will we continue to write papers on ‘indication’ of benefits of such and such a
project or is it time to start work on the paperwork already done in the preceding year. As long as paperwork is the oil that makes the machine go, we may never progress and the machine may continue to churn out … more paper.

Let’s see if in 2012 we finally learn from our decade of the mistake and not turn it into the mistake of the decade.

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I have just finished reading Salman Rushdie’s article in which he is quite vociferous in denouncing Pakistan as a terrorist state and all Pakistani bureaucracy and government agencies as allies of the fundamentalists.

‘Fundamentalists? The word itself is a misnomer and a huge one at that. Islam as a religion and a way of life is based on fundamentals and if you remove those the essence is lost.

Rushdie’s sentiments are strongly pro-Indian and equally anti-Pakistan. Below the article is a stream of supportive comments from all around the world. The article in question in addition is being circulated widely amongst international facebook and twitter users. There are very few who (judging by the feedback) hold back their passions rather than leapfrogging into a dynamite like rhetoric against ‘terrorism’, jihadis, fundos, beards and the like.

Let us for a moment leave religion out of this debate. What is left then? Salman Rushdie as one human denouncing a whole country full of millions of other humans on the basis of something that was or was not done by the ruling powers – that is shield Osama Bin Laden?

Alright, let us also suppose that they did shield him… and succeeded… on their own?

If Rushdie’s claim is correct, suddenly I feel like giving Pakistan a pat on the back! We succeeded in shielding OBL from the eyes of Big Brother? I’m dumbstruck.

Does anyone notice that the common man in Rushdie’s fantasia of a terrorist state has also been suffering due to intermittent bomb blasts and attacks? Does anyone care that several areas in the north ofPakistan had become no-go areas and that it is only recently that the army, which certain intellectuals have been denouncing repeatedly, has managed to clear those areas partially using its manpower – again the common man soldiers?

Religion happens to be one concept that ironically evokes passions in the breasts of even those who do not believe in any religion. Yet when Muslims protest against defamation of their ideals, it is taken as something akin to a stereotypical illiterate, uncouth, barbaric version of Conan the Barbarian.

Pronouncing judgement on a country never creates dialogue – it only creates hatred which in turn breeds more. Suddenly we have a rise of two clearly distinct viewpoints on the web. One professes the kill all the bearded ones hate tirade and the other sticks to its see what they are like? – Get-them-before-they-get-you part of the conversation.

And every debate has an audience. The ‘humans’ are watching and waiting – for judgement or Judgement day…

All around us in Pakistan, there is chaos waiting to happen nowadays. At times it is an accident, a politically motivated murder or even a suicide bombing. The deeper level outcome of this is at the end, the bubbling up of various aspects of the economy.

One of the implications can be directly seen in the oil and gas sector where again at present we can see a sharp incline. Petrol and gas prices increase almost every month – and the ceiling apparently has not been reached yet. There will come a time when the masses can take it no longer and perhaps this is a slump waiting to happen…

The cost of living is also high and increases by the day. The domino effect latches on to the property market where the bubbles are the most prominent. There are several who want to live in better places but do not have the buying power.

Among economic bubbles, a property bubble or real estate bubble is the inevitable product of speculative investment. It occurs cyclically in both local and global real
estate markets. Typical characteristics include rapid increases in property valuations followed by a severe ‘crash’. This occurs when prices have reached unsustainable levels relative to incomes etc.

Presently we are experiencing local bubbles or a little froth at least, in several parts of the
world including Pakistan. According to the Economist(2005), “the world wide rise in house prices is the biggest bubble in history”.

Economists have developed ratios and indicators for fair valuation of residential areas. A few indicators might be pointed out courtesy of economists striving to identify bubbles before they burst:

Bubbles can be identified by comparing current levels to previous unsustainable levels.

The valuation component measures affordability relative to current prices by mainly looking at the price to income ratio that is the ratio of median house price to median familial disposable incomes.

The debt component measures the debt incurred by households and bank loan accumulation by buying such property. When the ratio increases that is home ownership costs increase, households start depending on property values to service their debt or expenditure.

In case of real estate bubbles, the reality of experiencing one may not be as important as the slow and sure but difficult to identify tragedy of an impending house price crash. Some important points to keep in mind about price crashes are:

– After a bubble, the crash is a slower process, as sellers do not sell their own homes.

– Due to inflation in nominal terms prices stay flat for 3-5 years before a fall, which makes it trickier to spot the crash.

– Office, hotel and retail sectors share the same trend as residential sectors.

Pakistan’s macroeconomic foundations seem shaky. Developing countries following inward growth oriented approaches have faced crashes. Growth needs to be sustained
through exports and manufacturing than an obsession with volatile property markets. The select hundred thousand of the main beneficiaries are by and large exempt from the brunt of taxation. Levying tax would surely burst the bubble, but at the same time increase affordability for the masses. Only the landowners get rich when property prices go up while a nation can get rich only when the labour prices (salaries) go up.